Well-being In Pregnancy Research Articles

Assessing the Validity of the Long-Term Conditions Questionnaire (LTCQ) in Women During Pregnancy and the First Year Following Birth.

BackgroundThe aim of this study was to validate a generic patient-reported outcome measure, the Long-Term Conditions Questionnaire (LTCQ), among pregnant and postpartum women living with a pre-existing long-term condition (LTC).MethodsCognitive interviews were conducted with women who were currently pregnant or had given birth within the past year and living with a pre-existing LTC (n=11) and with healthcare professionals working in maternal care (n=11) to explore the acceptability of LTCQ items. An online survey was subsequently administered among women who were pregnant or had given birth within the past year and living with a pre-existing LTC (n=718). Tests of validity were performed including assessing correlations between the LTCQ and reference measures, the Well-being in Pregnancy (WiP) Questionnaire and the EuroQol EQ-5D-5L. Internal consistency was assessed using the Cronbach’s alpha statistic.ResultsAll LTCQ items were considered relevant and appropriate for use with women who were pregnant or had given birth within the past year. The most commonly reported LTC among the online survey sample (n=718) was a mental health condition (n=350, 48.7%) followed by joint, bone and connective tissues (n= 212, 29.5%) and gastrointestinal (n=143, 19.9%) condition. Data indicated LTCQ scores behaved in a predictable pattern, demonstrating poorer scores for women reporting a greater number of LTCs; mean (SD) scores, one LTC= 61.86 (17.8), two LTCs= 55.29 (16.0), three LTCs= 49.84 (15.52) and four LTCs= 44.94 (12.2). Poorer scores were also reported for women living with at least one mental health condition compared to those reporting no mental health condition, mean score = 66.18 (SD 16.7) v 48.64 (SD 13.3), p<0.001 respectively. As anticipated, LTCQ scores demonstrated significant correlations in the expected direction with both the EQ-5D-5L and WiP scores. For all LTCQ items, the Cronbach’s alpha statistic was 0.93.ConclusionData presented here indicate that the LTCQ, which assesses living well with one or more LTC, is suitable for use among pregnant and postpartum women, from both the woman’s perspective and from the perspectives of maternity healthcare professionals. Use of the LTCQ would facilitate the identification of unmet needs within this high-risk cohort and support the exploration of how LTCs may affect women throughout the pregnancy and post-natal period. Understanding unmet needs within this cohort of women provides an opportunity to link up specialist care within maternity services and enhance personalised care.

The adaptation of the Well-Being in Pregnancy (WiP) Questionnaire into Turkish: validity and reliability of a questionnaire

This study aimed to adapt the Well-Being in Pregnancy (WiP) Questionnaire into Turkish and assess the instrument’s validity and reliability in pregnant women. Exploratory factor analysis (EFA) was applied to 500 pregnant women included in Sample I, while confirmatory factor analysis (CFA) was applied to 386 pregnant women in Sample II. As a result of the EFA applied to Sample I, it was found that the 12-item WiP encompasses two factors (Positive Affect and Satisfaction subscale and Concerns subscale), and as a result of the CFA applied to Sample II, it was found that the scale has good fit indices (χ 2/df = 1.990, p = .000, CFI = 0.95, GFI = 0.95, AGFI = 0.93, RMSEA = 0.04, and PCLOSE = 0.000). The Cronbach’s alpha internal consistency coefficients that were obtained as a result of the reliability analyses of the scale were found as 0.72, 0.70 and 0.60 for all items of WiP, its first subscale and its second subscale, respectively. It was found that the item-total correlations of the scale varied in the range of r = 0.44–0.55 (p < .001). In the test–retest analysis, a statistically significant positive correlation was found between the total scores of the scale obtained in two different implementations (r = 0.412, p = .024). This study supported the use of WiP as a valid and reliable instrument for Turkish pregnant women. Impact Statement What is already known on this subject? The Well-Being in Pregnancy (WiP) Questionnaire developed in 2017 by Alderdice et al. is a measurement tool that is used to determine the positive and negative emotions of pregnant women. This questionnaire has not been translated to other languages. What do the results of this study add? The reliability and validity of the Turkish version of WiP were found to acceptable, and two subscales were identified as the Positive Affect and Satisfaction subscale and the Concerns subscale. What are the implications of these findings for clinical practice and/or further research? This reliable and valid instrument can be used for measuring the whole spectrum of well-being rather than just poor psychological health.

Refinement of the Well-being in Pregnancy (WiP) questionnaire: cognitive interviews with women and healthcare professionals and a validation survey

BackgroundMeasuring positive and negative aspects of well-being during pregnancy and childbirth is important for both healthy women and women who are living with long-term health conditions (LTCs). This study aimed to further refine the Well-being in Pregnancy (WiP) questionnaire and to incorporate LTC specific items where appropriate.MethodsA multi-method study. Cognitive interviews with pregnant or postpartum women (n = 11) and consultations with healthcare professionals (n = 11) and public representatives (n = 4) were conducted to explore the acceptability of existing WiP items and content. Items were refined and subsequently administered on an online survey (n = 768). Item reduction steps and exploratory factor analysis were performed on survey data. Convergent validity was examined using Pearson correlation coefficients to compare relationships with other included validated assessments.ResultsFollowing amendments to three items, the addition of eight core WiP items and five LTC specific items, a total of 25 items were considered relevant and appropriate for use with pregnant women. Analysis of survey data reduced the questionnaire to 12 items measuring three core WiP scales; 1) Concerns over support after birth, 2) Positive pregnancy and, 3) Confidence about motherhood, and a five item standalone LTC specific scale. All scales demonstrated good validity and internal reliability. Scores for the three core scales moderately correlated with established well-being measures indicating that they were measuring similar, yet distinct concepts.ConclusionsAnalyses confirmed good psychometric properties of the refined WiP questionnaire. The use of pregnancy specific well-being measures, such as the WiP, provide a route into asking women in more detail about how their care may be tailored to support them and also facilitates positive conversations with women about how care and experience of pregnancy and childbirth may be enhanced further.

Preliminary evaluation of the Well-being in Pregnancy (WiP) questionnaire

Background: The concept of well-being is multi-faceted by encompassing both positive and negative emotions and satisfaction with life. Measuring both positive and negative thoughts and emotions is highly relevant in maternity care that aims to optimise a woman’s experience of pregnancy and childbirth, focussing on positive aspects of health and well-being, not just the prevention of ill health. Yet our understanding of well-being in pregnancy and childbirth is limited as research to date has focussed on negative aspects such as stress, anxiety or depression. The primary aim of this study is to describe the psychometric properties of a newly developed Well-being in Pregnancy (WiP) questionnaire.Methods: A cohort study of 318 women attending hospital antenatal clinics in Belfast completed a questionnaire including three general well-being measures (not pregnancy specific) and the newly developed WiP questionnaire. The psychometric properties of the questionnaire were analysed using correlations to explore the relationship between the WiP questionnaire with the generic well-being measures administered at the same time and exploratory factor analysis was conducted.Results: The overall Cronbach’s alpha of the WiP was 0.73. Principal factor analysis was run on the WiP items and two factors were identified, one reflecting positive affect and satisfaction (Cronbach’s alpha = 0.718) and the other concerns (Cronbach’s alpha = 0.702). Both the overall WiP score and WiP sub-scale scores displayed significant correlations with the other well-being scales (r = 0.235–0.527).Conclusions: Measuring well-being in pregnancy is an important step in understanding the potential physical, psychological and social benefits of pregnancy and in understanding how well-being can be enhanced for women and their families at this important life stage. The initial psychometric data presented for the WiP questionnaire are encouraging. Most importantly, the measure provides an opportunity for women to express positive and negative emotions and thoughts about their pregnancy thus reflecting the whole spectrum of well-being.